Improvement of urinary tract symptoms in patients who underwent robot-assisted prostate surgery

The main aim of this study was to assess urinary tract symptoms (LUTS) in prostate cancer patients following robotic-assisted laparoscopic prostatectomy (RALP). The authors concluded that the majority of patients with moderate to severe LUTS improved significantly following RALP.

RALP is a relatively new procedure used to surgically remove the prostate gland. This involves multiple small incisions using robotic assistance to remove the prostate, seminal vesicles (tube-like glands which make semen) and occasionally the lymph nodes. 

LUTS are side effects that affect the urinary system after surgery which can be mild, moderate to severe. This can include kidney infections and/or bladder infections that lead to pain while urinating, the urge to pass urine frequently and blood in the urine. It is not clear what effect RALP has on urinary side effects. 

The main aim of this study was to determine LUTS in patients who received RALP. 

938 patients were used in this study. Each patient underwent RALP. Before surgery 55.8% of men experienced mild LUTS. 36.4% experienced moderate LUTS. 7.8% experienced severe LUTS. 

At the 6 month follow-up 84.8% were continent (control over bladder function), with 77.9% of these patients using zero incontinence pads. Patients with mild LUTS had a continence rate of 87.3% compared to patients with severe LUTS who had a rate of 77.8%.

The majority of patients with moderate or severe LUTS experienced an improvement in their symptoms following RALP. Men with severe LUTS experienced the biggest improvement. Patients with moderate LUTS also saw improvments. However, patients with mild LUTS experienced an increase following surgery. At the 6 month follow-up 61.3% reported mild LUTS, 35.2% reported moderate LUTS and 3.5% reported severe LUTS after RALP. 

Overall 27.2% of patients experienced an improvement in LUTS after RALP. 20.1% of patients reported an increase in symptoms after RALP.

The authors concluded that the majority of patients with moderate to severe LUTS improved significantly following RALP and that RALP was a viable treatment in these patient groups.